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<br /> � `t-, All iiiforinatiozz i�ust be subnutte�l in k'a.zl( ��:i���aa.•�� �a,A��.�A r���ia���Y� v��n'I_� �9a�� ;,a��x•&��,
<br /> ��lease�l�r'aat rzC�'ir�/'�aa°��aAa�rs�,rr��
<br /> r�II�±, APPLICANT �S: (ci��cle or�e) �)��%I'V��:�a. �.a�£. t:��i�f'(��",f'�.�;�"T'ri��t�
<br /> J�O�S�TE ADDI�E�S: _���-- . ���y._._� ��� I.�J �.��a �,,�� �-,,'�
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<br /> �,�i11 this be a �Pa�•adc of F,Ioines, Renioclel��rs �5�ao���c��as� �t��A��.� +�z�� o��i����� fll�ispl�jr i�.�ox��e';
<br /> ❑ Yc:S � NO I�f;>>es, a specia/evenl pe��niit is rcc�r.�r��ed lvitit�'t�lic;e L���pai�lt�i�ejzr u�2d City r'o��rtcil r,i��prov�il
<br /> 60 days�n�ior to the ever�t. 5'l��tittle btts ser�vice tivill he t�>c�t�irr_�r.1 u�2less a��plic.cr,r�tr�enGu��,strutes
<br /> st�fcin.nt on-sile pcu�Icin,is cavailt.ible. ��1a�t-��er•rtaitr`ecl er%erar's�4i'ill�aot be cillorvecf.
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<br /> .���}� � ��i� t.�u � (Wc)tl�)_�'r'�� ��' ,�,'��
<br /> 192�II��NG�.JDI)�ZI�SS n-.-�����7�`��' „�- �'.��'�R , . .,�„�'_�"'�; � g�"`��.- x-- '�1[�a� �"""� �4E ;�
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<br /> ��.IZCI�IT'1C�r�'/ENUI1i'LA��R: �������_�.�_ Q��� ` �A��`��1>t�"+'° `�a ��� m" M1 ,�r ;�'k1�'+�,_:r
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<br /> 1���1�L�NG�.I)I)��ES�: �, ��,� ��-'--�- ` ��� rt'1;'�'� � tT �� t� �,�' ��ry�'� ..�,�,�,f�,
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<br /> ��'�'A'� Ol� �VO�ZT�: New �— 11dc{.i.ti.oz� t�c,�c,�soa�y`:1:.i,�..uuti����
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<br /> Move Home t�f�iza.o���,i/.��l�t�,;r��ti��rz
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<br /> �'Id.C��'�S�ll��'OIZ��(desa�ibe iri �le�ni��e.--��„�..� ����._.._����:�',.,��� � t"� k"-�''—��.���``�,�'��.
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<br /> I`�I��. �� ������OIV�S: �C�A�Rf��;�' �'�'�"��„�1;�, ;`, �„�','���t �H�i',�� X ���E'1{����'���?��
<br /> k+'�'�'�I°o��.�'�IA Q��I�+I�"A'7tZUJ�`P,��I�I��l�A_,�1f4,'�'ll.�!�I I��rA;�n���cltrai,; ?rtnrasii�� �'' �� �1,.l�..�.1 r~- --
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<br /> I hrceby apply for a buildin_g permit and I acki�o�>vled�;e,tl�<�lt il��e i�il�oc���rt������� <2� vr. i;; c��oij�let� ulcJ �a;uratc;
<br /> th�t tlie worl< will be in contormance witl.l tl.te oidii�<ulc�s azl�l co�lc�� -��l��tkie t;ity�uc<l will� tJie �;ta�ti� f3i.lilciill;
<br /> Code; t,liat 1 u.ndeistancl tl�is is�1ot a j��ermii:aiid werlc is not to �:ta�.�r. �vi(�!��+.�i,Gt a��errz�_i.l�.; a��d t}i._r.t thr�wt�rl<:�-vi.11 t+e
<br /> in accorclance with tlze approved plazl. �
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<br /> �PI'L,ACAI�'I''S SIUNA`1C�JIZ�: � '� ,/ � ��r�'�'Bt;, �
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